Heatwave Related Health Education For Older People In The Community

Objectives A self-controlled interventional study was designed to examine the effects of pre-designed health education package about heatwaves on knowledge,attitudes and practices for older community residents,to explore the proper method of health education for the elderly in community,to enhance the ability to cope with extreme weather and to prevent disease from occurring or worsening,and to provide evidence for future public health services.Methods A convenience sampling method was used from July 10 to September 5 in 2017 and residents in the target community who met the inclusion criteria were recruited.During the first encounter,the researchers first completed the baseline survey including the socio-demographical information,the vulnerable elders survey,the available resources for adaptation to high temperature weather and the related knowledge,attitudes and practices questionnaire,then delivered the face-to-face oral instruction combining the educational material.And phone followed-ups were carried out twice,i.e.two and four weeks later respectively.The data were statistically analyzed by parametric test(such as analysis of variance for repeated measures)and nonparametric test(such as Mann-Whitney U test,Kruskal-Wallis H test and Spearman rank correlation).Results1.A comparison of these days between three periods of Dog Days in 2017 revealed that there was no significant difference in the daily maximum temperature during the three periods,but the daily minimum temperature gradually decreased(P<0.001)from the initial phase(26.10?),the middle period(24.35 ?)to the last phase(22.70?).The average daily temperature in the initial phase(30.00?)was significantly higher than that in the other two periods(P = 0.013).The wind speed of the initial phase(4.39m/s)was greater than that of the middle phase(1.97m/s).And the air quality of the initial phase(55.00)was superior to that of the middle phase(94.25).Two heatwaves occurred during the study period.The daily maximum temperature(37.00 ?),minimum temperature(28.00 ?)and mean temperature(32.50 ?)in the first heatwave were higher than those in the second heatwave(P<0.05).But the wind speed of the first heatwave(4.80m/s)was greater than that of the second heatwave(1.10m/s).2.A total of 114 eligible participants were approached and recruited.60(52.6%)completed the initial questionnaire survey and heatwaves related health education as well as two follow-ups after two and four weeks,respectively.3.The knowledge,attitudes and practices questionnaire was scored significantly different across three time points,i.e.baseline and two follow-up(P<0.001).The dimension of Risk Awareness was scored more highly at the first follow-up(17.45)than that at the baseline(16.77)and the second follow-up(17.18);the scores of the overall questionnaire and the dimension of Coping Attitudes and Adaptive Behaviors had a significantly higher score at the second follow-up,i.e.99.30,19.48 and 62.63 respectively.4.Many factors had a significant effect on the score of the knowledge,attitudes and practices questionnaire,that is,education,risk exposure,medical history,family history,disability,air conditioner,water shortage,public green areas nearby,early alert of heatwaves,access to weather or heatwaves information and frequent contact with neighbors.5.Spearman correlation analyses showed a strong negative relationship between the distance to the nearest health services and the score of the overall questionnaire(rs=-0.369,P<0.001),Risk Awareness(rs=-0.275,P<0.01),Coping Attitudes(rs =-0.287,P<0.01)and Adaptive Behaviors(rs =-0.297,P<0.01),respectively.The score of VES-13 was also found negatively correlated with the score of the overall questionnaire(rs-0.211,P<0.05)and Coping Attitudes(rs=-0.243,P<0.01),respectively.Further analyses showed that the score of limitation in physical function was negatively correlated with the score of the overall questionnaire(rs =-0.195,P<0.05)and Adaptive Behaviors(rs =-0.186,P<0.05),respectively,so was the score of functional disabilities with the score of the overall questionnaire(rs =-0.205,P<0.05)and Adaptive Behaviors(rs =-0.200,P<0.05),respectively.Conclusion Older people are vulnerable to extreme hot weather.The individualized health education and telephone follow-up centering high temperature and health may have an.enduring effect on older people's adaptation to hot days including heat waves.Healthcare providers should provide relevant education for older residents to help them enhance the ability to cope with extreme weather and to prevent disease from occurring or worsening,and to reduce the adverse health effects.